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[留置膀胱导管相关的尿路感染:发病率及危险因素]

[Urinary tract infection associated with indwelling bladder catheter: incidence and risk factors].

作者信息

Stamm A M, Coutinho M S

机构信息

Departamento de Clínica Médica do Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis.

出版信息

Rev Assoc Med Bras (1992). 1999 Jan-Mar;45(1):27-33. doi: 10.1590/s0104-42301999000100007.

Abstract

BACKGROUND

To determine the incidence and risk factors associated with urinary tract infection (UTI) in patients submitted to long-term urinary (bladder) catheterization. One hundred and thirty-six patients who had urinary catheterization during the period of may to december 1993 at an University Hospital in Brazil.

MATERIAL AND METHOD

Observational prospective cohort non-controlled study. Patients receiving bladder catheter were followed from insertion to removal of the catheter, looking for the development of a positive culture. Urine cultures were done using conventional media for aerobic organisms and biochemical tests for identification. Material from a urethral meatus swab was also examined for bacteria. Statistical analysis using parametric tests for cathegorical and continuous variables, and multivariate analysis for determination of risk factors for UTI were performed.

RESULTS

Incidence of UTI associated with urinary catheter was 11.0%. Univariate analysis showed 3 factos as predictors: the nature of his disease (clinical or surgical) (p = 0.01), stayed during hospitalization in one clinic (p = 0.02) and duration of catheterization (p = 0.00003). In the multivariate analysis only the duration of catheterization was statistically significant. (p = 0.03).

CONCLUSIONS

Incidence of UTI associated with urinary catheters in the analysed sample was 11.0%, because in the University Hospital there is a control of the alterable risk. Catheterization duration is an important risk factor for this problem. It is recommended to limit to the minimum the time of catheterization in hospitalized patients.

摘要

背景

确定长期留置导尿管(膀胱)的患者中尿路感染(UTI)的发生率及相关危险因素。1993年5月至12月期间,巴西一所大学医院的136例患者接受了导尿术。

材料与方法

观察性前瞻性队列非对照研究。对接受膀胱导尿的患者从导尿管插入到拔除进行随访,观察是否出现培养阳性。使用常规培养基进行需氧菌尿液培养,并通过生化试验进行鉴定。还对尿道口拭子材料进行细菌检查。对分类变量和连续变量使用参数检验进行统计分析,并进行多变量分析以确定UTI的危险因素。

结果

与导尿管相关的UTI发生率为11.0%。单变量分析显示3个因素为预测指标:疾病性质(临床或手术)(p = 0.01)、在一个科室住院时间(p = 0.02)和导尿持续时间(p = 0.00003)。多变量分析中只有导尿持续时间具有统计学意义(p = 0.03)。

结论

在所分析的样本中,与导尿管相关的UTI发生率为11.0%,因为在大学医院对可改变的风险进行了控制。导尿持续时间是该问题的一个重要危险因素。建议将住院患者的导尿时间限制到最短。

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